Health Insurance & Pension Enrollment in Japan (2026): A Newcomer's First-Weeks Guide

Quick answer (30 seconds): Public health insurance and pension are mandatory for foreign residents in Japan — they are not optional. If your employer enrolls you in company insurance (Shakai Hoken / 社会保険), that single enrolment usually covers both your health insurance and your pension, and your company handles it. If you are not on company insurance (student, freelancer, part-timer, dependent, between jobs), you enroll yourself at your city or ward office in National Health Insurance (国民健康保険 / kokuho) and National Pension (国民年金). Do it in your first weeks, right after you register your address. And from June 2027, unpaid premiums can block a visa renewal — so getting this right early protects your status later.

ℹ️ Amounts and reduction rules differ by municipality and by your income. Treat the figures below as typical guidance and confirm the exact numbers and counters with your own city/ward office.

The two systems, and which one applies to you

There are two public obligations, and how you join them depends on your work situation:

	If your employer enrolls you (Shakai Hoken / 社会保険)	If you enroll yourself (national plans)
Health insurance	Employees' Health Insurance — via your company	National Health Insurance (国民健康保険) at the city/ward office
Pension	Employees' Pension (厚生年金) — via your company	National Pension (国民年金) at the city/ward office
Who handles it	Your employer (deducted from salary)	You, at your municipal office
Typically applies to	Full-time company employees (and some part-timers)	Students, freelancers, many part-timers, dependents, people between jobs

The key takeaway: if you're not on company insurance, the responsibility is yours, and you handle both at the same place — your local city or ward office.

When and where to enroll

The sequence matters, because almost nothing at the municipal office works until your address is registered:

1. Register your address first. When you move in, you register your residence at your city/ward office (this is your jūminhyō residential registration). This is the gateway to every other municipal service.
2. Go to the National Health Insurance counter at the same office and ask for the NHI enrollment form. Public health insurance enrollment is generally required for anyone staying in Japan three months or more who isn't covered by company insurance.
3. Handle National Pension at the pension/national-pension counter in the same building (or as directed). If you're 20 or older and not in the employees' pension, you join the National Pension.

Doing all of this in one trip, soon after you arrive, saves you a second journey and avoids gaps in coverage.

If your company puts you on Shakai Hoken, you usually don't do the NHI/National-Pension steps — your employer's enrollment replaces them. Confirm with your HR which system you're on.

Documents to bring (newcomers)

Bring originals. A typical newcomer set:

• Residence card (在留カード)
• Passport
• My Number card (or your My Number notification letter)
• If you hold a Designated Activities (特定活動) status: the Designation Sheet that comes with your passport
• Your address details (and proof you've completed residence registration)
• A bank account / cash card if you want to set up direct-debit payment for premiums

Requirements can vary slightly by municipality, so it's worth checking your city/ward office's website (many have English pages) before you go.

What it costs and how reductions work

This is the part that genuinely varies, so treat all numbers as "ask locally":

• National Health Insurance premiums are calculated from your previous year's income and your municipality's formula. A newcomer with little or no Japanese income from the prior year often pays a lower premium at first, and income-based reductions may apply.
• National Pension has a set monthly contribution, but if you can't pay, there are official routes — exemption, reduced contribution, and (for some) a student payment-postponement system. You generally have to apply for these; they aren't automatic.
• Don't simply skip payments. If money is tight, apply for an exemption or reduction rather than letting premiums go unpaid — which matters more than ever (see next section).

For the detail on lowering or deferring pension contributions, and on refunds if you later leave Japan, see our dedicated guides linked at the bottom.

Why this matters from June 2027

A significant policy change makes correct enrollment more than a formality. Under a rule announced by the health minister on 2025-11-04 and adopted at an inter-ministerial meeting on 2026-01-23, from June 2027 foreign residents with unpaid National Health Insurance premiums or National Pension contributions will, in principle, face denial of visa renewal or status change.

In plain terms: unpaid kokuho or pension could one day cost you your ability to stay. The protective move is simple — enroll on time, pay on time, and if you can't pay, file for an official exemption or reduction so there's no "unpaid" record hanging over a future renewal.

Re-check the exact scope and start details of this rule with official Immigration / MHLW sources before you rely on specifics — policy implementation details can be refined.

First-weeks checklist

• Register your address at the city/ward office (do this first).
• Confirm with your employer whether you're on Shakai Hoken (if so, you're largely set).
• If not on company insurance: enroll in National Health Insurance at the NHI counter.
• If 20+ and not in employees' pension: enroll in National Pension.
• Bring residence card, passport, My Number (and Designation Sheet if on 特定活動).
• Set up payment (direct debit or payment slips) and keep records.
• If money is tight, apply for a pension exemption/reduction rather than skipping.
• Keep proof of enrollment/payment — useful for future visa renewals.

FAQ

1. Is health insurance really mandatory? I'm healthy. Yes. Public health insurance is compulsory for residents staying three months or more who aren't on company insurance — it's a legal obligation, not a personal choice. The upside: it covers a large share of medical costs when you do need care.

2. My company enrolled me in Shakai Hoken. Do I still go to the city office? Generally no for insurance/pension — your employer's enrollment covers both. You still register your address at the city office. Confirm your situation with HR.

3. I have almost no income. Do I have to pay full premiums? Often not. NHI premiums are income-based, and pension has exemption/reduction routes — but you usually must apply. Don't just skip payments; file for relief.

4. What if I'm leaving Japan in a year or two? You still enroll while you're here. When you leave, you may be eligible for a pension lump-sum withdrawal (脱退一時金) — see our refund guide. Enrolling now and refunding later is the correct order, not skipping.

5. Why does unpaid insurance affect my visa? From June 2027, unpaid NHI or pension can, in principle, block visa renewal or status change. Staying enrolled and paid (or on an approved exemption) keeps your record clean for renewals.

Sources

• Japan Pension Service (official, English) — National Pension enrollment, contributions and exemptions: https://www.nenkin.go.jp/international/index.html
• Ministry of Health, Labour and Welfare (MHLW), English — public health insurance overview: https://www.mhlw.go.jp/english/
• Ritsumeikan International Center — plain-English explainer of National Health Insurance and National Pension: https://global.support.ritsumei.ac.jp/hc/en-us/articles/26129118394899-Understanding-National-Health-Insurance-and-National-Pension
• Kantenna — Health insurance in Japan for foreigners, complete 2026 guide (mandatory enrollment, documents, and the 2027 visa rule): https://kantenna.com/series/health-insurance-japan-foreigners-complete-guide-series/health-insurance-japan-foreigners-complete-guide

Related guides

• National Pension exemption guide — how to reduce or defer contributions when money is tight
• Japan pension refund guide — the lump-sum withdrawal when you leave Japan
• Pension lump-sum (脱退一時金) for foreigners — eligibility and how to claim
• First 7 days in Japan checklist — address registration, insurance, and the rest of your setup
• Moving in & My Number guide — get the address registration and My Number that enrollment requires

Last updated: 2026-06-20